scholarly journals Changes In Gait Biomechanics As Functional Symptom Of Chondromalacia Patella

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Aljona V. Altukhova ◽  
Sergey N. Kaurkin ◽  
Dmitry V. Skvortsov ◽  
Alexander A. Akhpashev ◽  
Nikolay V. Zagorodniy

The goal of this research was to investigate functional and biomechanical symptoms in patients with chondromalacia patella. Material and Methods — Gait biomechanics was assessed in 35 patients with diagnosed unilateral chondromalacia patella and in 20 healthy adult controls. We recorded hip and knee movements, impact loads and temporal characteristics of the gait cycle (GC) during self-paced walking. Results — The temporal characteristics of gait and the impact loads remained normal in the patient population. Hip flexion amplitude decreased both on the affected (p=0.002) vs. unaffected (p=0.016) sides, compared to healthy control, whereas the amplitude phase increased on the affected (p=0.012) vs. unaffected (p=0.001) sides, versus healthy control. Hip extension and adduction-abduction amplitudes did not change significantly. Stance-phase and swing-phase knee flexion amplitudes did not change significantly. Knee extension amplitude on the affected limb increased (p=0.015), and knee rotation on the unaffected limb decreased versus control (p=0.016). The so-called stairstep symptom defined in the study was found in 83% of patients: in 23 patients bilaterally and in 6 patients unilaterally. Conclusion — Chondromalacia patella affected the gait biomechanics on both sides. The changes in the kinematic patterns during the flat-surface walking were not substantial. The only pathognomonic functional symptom of the condition was the stairstep symptom.

2013 ◽  
Vol 38 (6) ◽  
pp. 447-455 ◽  
Author(s):  
Valerie J Eberly ◽  
Sara J Mulroy ◽  
JoAnne K Gronley ◽  
Jacquelin Perry ◽  
William J Yule ◽  
...  

Background: For individuals with transfemoral amputation, walking with a prosthesis presents challenges to stability and increases the demand on the hip of the prosthetic limb. Increasing age or comorbidities magnify these challenges. Computerized prosthetic knee joints improve stability and efficiency of gait, but are seldom prescribed for less physically capable walkers who may benefit from them. Objective: To compare level walking function while wearing a microprocessor-controlled knee (C-Leg Compact) prosthesis to a traditionally prescribed non-microprocessor-controlled knee prosthesis for Medicare Functional Classification Level K-2 walkers. Study design: Crossover. Methods: Stride characteristics, kinematics, kinetics, and electromyographic activity were recorded in 10 participants while walking with non-microprocessor-controlled knee and Compact prostheses. Results: Walking with the Compact produced significant increase in velocity, cadence, stride length, single-limb support, and heel-rise timing compared to walking with the non-microprocessor-controlled knee prosthesis. Hip and thigh extension during late stance improved bilaterally. Ankle dorsiflexion, knee extension, and hip flexion moments of the prosthetic limb were significantly improved. Conclusions: Improvements in walking function and stability on the prosthetic limb were demonstrated by the K-2 level walkers when using the C-Leg Compact prosthesis. Clinical relevance Understanding the impact of new prosthetic designs on gait mechanics is essential to improve prescription guidelines for deconditioned or older persons with transfemoral amputation. Prosthetic designs that improve stability for safety and walking function have the potential to improve community participation and quality of life.


2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0051
Author(s):  
Pinar Melodi Caliskan ◽  
Anne Benjaminse ◽  
Alli Gokeler

Introduction: Injuries of the anterior cruciate ligament (ACL) commonly occur during complex game situations when the athlete encounters multiple factors such as ball, opponent, field position, and game strategy (Grooms et al., 2018). Many of the current traditional injury screening programs are performed within a predictable, fixed or ‘closed’ environment which do not represent real game situations that require high neurocognitive demands (Dingenen & Gokeler, 2017; Grooms et al., 2018). A complementary approach to lab-based settings is necessary to incorporate the demands of the complex athletic environments. By using wearable sensor technology, we aim to develop an on-field injury screening test in elite youth male soccer players. Investigating the individual differences in motor coordination patterns of the players during sport-specific tasks might enhance our understanding of how ACL injuries occur. Hypotheses: We hypothesized that the motor coordination patterns of the players would be affected when they perform under different conditions manipulated with constraints (task and environmental). Methods: A football-specific test setup was created to analyse the kinematic and performance measures of a group of 17 male youth elite football players aged 15 years (height = 164 ± 9 cm, mass = 50.9± 7.4 kg). The players were grouped into two and measured on two consecutive days. All the players were instructed to complete the test setup (4 conditions, 5 trials) as fast as possible. Condition 1 includes no constraint, condition 2 includes a task constraint (football dummies), condition 3 includes an environmental constraint (stroboscopic glasses) (SENAPTEC, Beaverton, Oregon) and condition 4 includes both task and environmental constraints. 3-D kinematics of the hip, knee, ankle joints were captured using Xsens wearable full-body sensor suits (Xsens, MVN Link version, Enschede, The Netherlands). MATLAB (MATLAB R2019a, The MathWorks Inc., Massachusetts) was used to process and analyse the kinematic data. Data from condition 1 was determined as reference behavior/condition to be compared to other conditions. Kinematic data are presented in attitude vectors (ATV). Results: In total, 81% of the players demonstrated a significant difference (P < 0.05) in angles of hip, knee and ankle joints when performing under different conditions. The percentage of players with increased comparison-based joint movements as follows; condition 1 to condition 2 comparison; 41% hip flexion, 59% hip extension, 53% hip abduction, 47% hip adduction, 62% knee flexion, 38% knee extension, 59% knee abduction, 41% knee adduction, 47% ankle dorsiflexion, 53% ankle plantarflexion, condition 1 to condition 3 comparison; 35% hip flexion, 65% hip extension, 47% hip abduction, 53% hip adduction, 50% knee flexion, 50% knee extension, 41% knee abduction, 59% knee adduction, 59% ankle dorsiflexion, 41% ankle plantarflexion and condition 1 to condition 4 comparison; 31% hip flexion, 69% hip extension, 38% hip abduction, 62% hip adduction, 60% knee flexion, 40% knee extension, 44% knee abduction, 56% knee adduction, 69% ankle dorsiflexion, 31% ankle plantarflexion. Conclusion: The result of this pilot study demonstrated that manipulating task with different constraints caused significant changes in players’ motor coordination patterns which supported the hypothesis of our study. Our findings suggest to develop ACL injury screening tests in a sport-specific setting.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0235582
Author(s):  
Pedro Vieira Sarmet Moreira ◽  
Coral Falco ◽  
Luciano Luporini Menegaldo ◽  
Márcio Fagundes Goethel ◽  
Leandro Vinhas de Paula ◽  
...  

The aim of this study is to analyze how isokinetic knee and hip peak torques and roundhouse kick velocities are related to expertise level (elite vs. sub-elite) in taekwondo athletes. Seven elite and seven sub-elite athletes were tested for kick-specific variables (KSV, composed of kinematic variables and power of impact) and for concentric isokinetic peak torque (PT) at 60°/s and 240°/s. First, KSVs and PTs were compared between groups, then PTs were correlated with KSVs. Parametric variables with larger effect sizes (Cohen’s d) were entered in a stepwise linear discriminant analysis (LDA), generating an equation to estimate competitive level. Between-group differences were found in hip flexors (p = 0.04, d = 0.92) and extensors (p = 0.04, d = 0.96) with PT at 240°/s. Hip flexion PT at 60°/s and 240°/s correlated negatively with kick time (R = –0.46, p = 0.0499 and R = –0.62, p = 0.01 respectively). Hip flexion torque at 60°/s correlated positively (R = 0.52, p = 0.03) with peak linear velocity of the foot (LVF) and power of impact (R = 0.51, p = 0.03). Peak torque of hip extension at 60°/s and hip abduction at 240°/s also correlated with LVF (R = 0.56, p = 0.02 and R = 0.46, p = 0.0499). Hip extension at 60°/s correlated positively with peak linear velocity of the knee (R = 0.48, p = 0.04). The LDA showed an accuracy of 85.7% (p = 0.003) in predicting expertise level based on hip flexion and extension torques at 240°/s and on knee extension velocity during the kick. The study demonstrates that hip muscle strength is probably the dominant muscular factor for determining kick performance. Knee angular velocity combined with hip torques is the best discriminator for competitive level in taekwondo athletes.


2020 ◽  
Vol 41 (13) ◽  
pp. 962-971
Author(s):  
Ahmad Alanazi ◽  
Katy Mitchell ◽  
Toni Roddey ◽  
Aqeel Alenazi ◽  
Msaad Alzhrani ◽  
...  

AbstractThe purpose of this study was to evaluate landing biomechanics in soccer players following ACLR during two landing tasks. Eighteen soccer players with an ACLR and 18 sex-matched healthy control soccer players participated in the study. Planned landing included jumping forward and landing on the force-plates, whereas unplanned landing included jumping forward to head a soccer ball and landing on the force-plates. A significant landing×group interaction was found only for knee flexion angles (p=0.002). Follow-up comparisons showed that the ACL group landed with greater knee flexion during planned landing compared with unplanned landing (p<0.001). Significant main effects of landing were found. The unplanned landing showed reduction in hip flexion (p<0.001), hip extension moments (p<0.013), knee extension moments (p<0.001), and peak pressure (p<0.001). A significant main effect for group for gastrocnemius muscle was found showing that the ACL group landed with reduced gastrocnemius activity (p=0.002). Unplanned landing showed greater injury predisposing factors compared with planned landing. The ACL group showed nearly similar landing biomechanics to the control group during both landing tasks. However, the ACL group used a protective landing strategy by reducing gastrocnemius activity.


2016 ◽  
Vol 32 (1) ◽  
pp. 78-85 ◽  
Author(s):  
Steven J. Elmer ◽  
John McDaniel ◽  
James C. Martin

One-legged cycling has served as a valuable research tool and as a training and rehabilitation modality. Biomechanics of onelegged cycling are unnatural because the individual must actively lift the leg during flexion, which can be difficult to coordinate and cause premature fatigue. We compared ankle, knee, and hip biomechanics between two-legged, one-legged, and counterweighted (11.64 kg) one-legged cycling. Ten cyclists performed two-legged (240 W), one-legged (120 W), and counterweighted one-legged (120 W) cycling (80 rpm). Pedal forces and limb kinematics were recorded to determine work during extension and flexion. During counterweighted one-legged cycling relative ankle dorsiflexion, knee flexion, and hip flexion work were less than one-legged but greater than two-legged cycling (all P < .05). Relative ankle plantar flexion and hip extension work for counterweighted one-legged cycling were greater than one-legged but less than two-legged cycling (all P < .05). Relative knee extension work did not differ across conditions. Counterweighted one-legged cycling reduced but did not eliminate differences in joint flexion and extension actions between one- and two-legged cycling. Even with these differences, counterweighted one-legged cycling seemed to have advantages over one-legged cycling. These results, along with previous work highlighting physiological characteristics and training adaptations to counterweighted one-legged cycling, demonstrate that this exercise is a viable alternative to one-legged cycling.


2021 ◽  
Vol 8 (11) ◽  
Author(s):  
Longfei Cheng ◽  
Caihua Xiong ◽  
Wenbin Chen ◽  
Jiejunyi Liang ◽  
Bo Huang ◽  
...  

Assistive devices are used to reduce human effort during locomotion with increasing success. More assistance strategies are worth exploring, so we aimed to design a lightweight biarticular device with well-chosen parameters to reduce muscle effort. Based on the experience of previous success, we designed an exotendon to assist in swing leg deceleration. Then we conducted experiments to test the performance of the exotendon with different spring stiffness during walking. With the assistance of the exotendon, peak activation of semitendinosus decreased, with the largest reduction of 12.3% achieved with the highest spring stiffness ( p = 0.004). The peak activations of other measured muscles were not significantly different ( p = 0.15–0.92). The biological hip extension and knee flexion moments likewise significantly decreased with the spring stiffness ( p < 0.01). The joint angle was altered during the assisted phases with decreased hip flexion and knee extension. Meanwhile, the step frequency and the step length were also altered, while the step width remained unaffected. Gait variability changed only in the frontal plane, exhibiting lower step width variability. We conclude that passive devices assisting hip extension and knee flexion can significantly reduce the burden on the hamstring muscles, while the kinematics is easily altered.


2020 ◽  
Author(s):  
Pedro Vieira Sarmet Moreira ◽  
Coral Falco ◽  
Luciano Luporini Menegaldo ◽  
Márcio Fagundes Goethel ◽  
Leandro Vinhas de Paula ◽  
...  

AbstractThe aim of the study was to analyzed the relationship between isokinetic knee and hip peak torques and Roundhouse-kick velocities and expertise level (Elite vs. Subelite) of Taekwondo athletes. Seven elite and seven sub-elite athletes were tested for kick kinematic, power of impact and for isokinetic peak torque (PT) at slow (60°/s) and high (240°/s) concentric mode. PTs were compared between groups and correlated with the data of kick performance. It was found inter-group differences in hip flexors and extensors PT at the isokinetic fast speed. The hip flexion PT at 60°/s and 240°/s were negatively correlated with the kick time (R = −0.46, and R = −0.62, respectively). Hip flexion torque at 60°/s was also positively correlated (R = 0.52) with the peak of linear velocity of the foot (LVF) and the power of impact (R = 0.51). Peak torque of hip extension at 60°/s and hip abduction at 240°/s were correlated with the LVF (R= 0.56 and R = 0.46). Discriminant analysis presented an accuracy of 85.7% in predicting expertise level based on fast torques of hip flexion and extension and on the knee extension velocity during the kick. This study demonstrated that hip muscles strength is probably the dominant muscular factor for determining kick performance. Knee angular velocity combined with hip torques are the best discriminators for the competitive level in taekwondo athletes.


2001 ◽  
Vol 13 (02) ◽  
pp. 53-65 ◽  
Author(s):  
K. A. KHALAF ◽  
M. PARNIANPOUR ◽  
T. KARAKOSTAS

The need to develop objective functional muscle torque capability models has been a major concern for exercise scientists, rehabilitation therapists, as well as biomechanists and ergonomists, for many decades. This study provides a surface response normative database of 3-D dynamic torque capability profiles for the lower extremity knee and hip joints for twenty normal males and females. The results of the regression analyses were presented for each subject per direction of exertion for each joint depicting a wide range of adjusted R2 values for each of the two joints (knee flexion: .26-.91, knee extension: .23-.80; hip flexion: .33-81, hip extension: .31-.80). Furthermore, the results showed that joint torque capability was significantly influenced by dynamic parameters such as the angular velocity, and that the interaction between angular position and velocity was highly significant. Such 3-D representation may be used as a "performance capacity envelope" to comprehensively characterize an individual's dynamic joint torque capability. Potential applications cover a broad spectrum ranging from rehabilitation to ergonomic and biomechanical applications and have significant implications in terms of guiding job assignment, return to work, as well as prognosis during the rehabilitation processes.


2019 ◽  
Author(s):  
Robert L. McGrath ◽  
Fabrizio Sergi

AbstractRobot assisted gait retraining is an increasingly common method for supporting restoration of walking function after neurological injury. Gait speed, an indicator of walking function, is correlated with propulsive force, a measure modulated by the posture of the trailing limb at push-off. With the ultimate goal of improving efficacy of robot assisted gait retraining, we sought to directly target gait propulsion, by exposing subjects to pulses of joint torque applied at the hip and knee joints to modulate push-off posture. Our previous work investigated changes in joint moments associated with push-off posture modulation, which informed the composition of 16 joint torque pulse conditions.In this work, we utilized a robotic exoskeleton to apply pulses of torque to the hip and knee joints, during individual strides, of 16 healthy control subjects, and quantified the effects of this intervention on hip extension and propulsive impulse during and after application of these pulses.We observed significant effects in the outcome measures primarily at the stride of pulse application. Specifically, when pulses were applied at late stance, we observed a significant increase in propulsive impulse when knee and/or hip flexion pulses were applied and a significant increase in hip extension angle when hip extension torque pulses were applied. When pulses were applied at early stance, we observed a significant increase in propulsive impulse associated with hip extension torque.


1999 ◽  
Vol 4 (1) ◽  
pp. 6-7
Author(s):  
James J. Mangraviti

Abstract The accurate measurement of hip motion is critical when one rates impairments of this joint, makes an initial diagnosis, assesses progression over time, and evaluates treatment outcome. The hip permits all motions typical of a ball-and-socket joint. The hip sacrifices some motion but gains stability and strength. Figures 52 to 54 in AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, illustrate techniques for measuring hip flexion, loss of extension, abduction, adduction, and external and internal rotation. Figure 53 in the AMA Guides, Fourth Edition, illustrates neutral, abducted, and adducted positions of the hip and proper alignment of the goniometer arms, and Figure 52 illustrates use of a goniometer to measure flexion of the right hip. In terms of impairment rating, hip extension (at least any beyond neutral) is irrelevant, and the AMA Guides contains no figures describing its measurement. Figure 54, Measuring Internal and External Hip Rotation, demonstrates proper positioning and measurement techniques for rotary movements of this joint. The difference between measured and actual hip rotation probably is minimal and is irrelevant for impairment rating. The normal internal rotation varies from 30° to 40°, and the external rotation ranges from 40° to 60°.


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